by Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA
November 19th, 2014
Each new year brings a bundle of surprises in terms of changes and updates that practices must learn and implement. In an effort to aid in the preparation of this year, I have listed some common helpful tips that you might follow in order to best manage your workload ahead.
Evaluate fees: Fee schedules are often compared to peers. Practices should use a reliable source to evaluate fees annually to ensure that your fee schedule is consistent with statistical expectations.
Update fees to comply with requirements: Medicare, Medicaid, Work Comp and even PI fee schedules can be, or are, updated at least annually. Check with your state and also CMS websites to be sure that your fees reflect those that are required for this new year.
Consider EHR: The majority of the medical world is making the transition to Electronic Health Records. If you haven't already made this transition, now would be a fantastic time to begin evaluating software and begin this transition yourself. Increased documentation requirements are estimated to take an additional 20% more time than most practices currently take. This means a loss of patient productivity, lesser revenues, and we are also put at higher risk for costly oversights and errors. EHR truly is the best step to take when working toward clean and thorough documentation.
Review Guidelines: PQRS and Meaningful Use are here to stay. Practices should make sure they understand and have properly implemented steps to clearly document and report, so as to fully comply with these guidelines.
Review documentation & record keeping requirements: Utilize your resources such as CMS, state organizations, ChiroCode manuals, software training, individual payers and many others that outline specific guideline for thorough documentation. One of the components in properly qualifying for payment is that your services must all be clearly and thoroughly documented. If it isn't documented, it didn't happen!
Review your code use: This means all of the diagnoses and CPT/HCPCS codes that are being used in your practice should be evaluated in detail. Services must all be supported by diagnoses and those services performed must all be clearly defined with the proper CPT/HCPCS code. Documentation and coding must always tell the same story! The best way to do this is by performing a Gap Analysis.
Begin training for ICD-10: The October 1, 2015 implementation date will be here before you know it. With almost 70,000 codes in ICD-10 (We currently have just over 14,000 with ICD-9), this is an enormous transition and learning curve. Doctors, coders, and all ancillary staff should become familiar with the impact of ICD-10 and be trained appropriately for their role. The current estimate indicates that approximately 80% of errors are expected with this transition on behalf of not only the practices and providers but also with the payers. The very best thing that a practice can do is to begin now to train and prepare for this transition. Doing so will help to limit errors on your behalf and limit the stress and uncertainty that is coming with this significant change.
Implement a Compliance Program for your practice: Compliance regulations are a great concern now and are quickly becoming a priority in all practice types. Compliance regulation such as HIPAA, OSHA and general practice compliance plans are currently and will continue to be your greatest tool for practice protection.
As you review the list above and include your own individual items that need to be addressed within your practice, make sure you have current year coding manuals and other tools. This will be helpful in your effort to prevent overwhelm. Practices must also schedule organized meeting and training sessions on a regular basis to work through your 'To Do' list in a manageable way. Reach out to ChiroCode as you begin working toward each of these things and ask for help where needed.